Healthcare Call Center Representative
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Job Description
Remote call center representative supporting Medicaid providers and members for Gainwell Technologies. Handling coverage, claims, benefits, and disputed-claim inquiries by telephone.
Responsibilities:
- Provide exceptional customer service by telephone to Medicaid providers and members
- Assist with coverage, claims, and benefit-related inquiries
- Accurately interpret Medicaid benefits and policy provisions
- Research and resolve disputed claims
- Ensure timely follow-up to achieve prompt resolution
- Answer inbound calls within 30 seconds
- Use multiple monitors/screens and systems to service calls
- Be a productive member of the team
- Comply with contract requirements, business unit rules, and related legal regulations
- Maintain time management, attendance, and punctuality
Requirements:
- At least one year of call center experience, preferably in healthcare, human services, or Medicaid
- Experience working in a metric driven environment
- Experience using an auto answer system
- Experience working in the Healthcare Industry / Medicaid specifically
- Experience meeting Service Level Agreements and contractual obligations
- Prior office or clerical experience
- Ability to learn and ask questions to be independent
- Ability to follow written policies, procedures, and procedural guidelines
- Ability to access and retrieve information using a PC
- Basic understanding of Microsoft Office products
- Ability to work on assignments with limited instructions from leadership
- Good written and verbal communication skills, including professional telephone skills
- Dedicated home office or private workspace with a door
- Availability Monday through Friday, 8:00 AM to 5:00 PM
- Punctuality and reliable attendance
Benefits:
- Work flexibility
- Learning and career development
- Generous, flexible vacation policy
- 401(k) employer match
- Comprehensive health benefits
- Educational assistance
- Leadership and technical development academies
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